Upstate Cerebral Palsy, Inc. | |
1002 Oswego St Utica NY 13502-5031 | |
(315) 798-8868 | |
Not Available |
Full Name | Upstate Cerebral Palsy, Inc. |
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Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
Location | 1002 Oswego St, Utica, New York |
Authorized Official Name and Position | Geno Decondo (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 3157246907 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Upstate Cerebral Palsy, Inc. 125 Business Park Dr Utica NY 13502-6305 Ph: (315) 724-6907 | Upstate Cerebral Palsy, Inc. 1002 Oswego St Utica NY 13502-5031 Ph: (315) 798-8868 |
NPI Number | 1215098207 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 04/05/2023 |
Certification Date | 04/05/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1215098207 | NPI | - | NPPES |
01039156 | Medicaid | NY |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | 01039156 (New York) | Primary |
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